Out There

school reform

Posted in teaching by Pete on September 30, 2018

What is the point of the educational system in place in America today?  There are some very fundamental differences of opinion about this.

Do schools exist to teach our kids?  Yes.  Teach them what?  (Values?  Lists of facts?  How to think?  How to get along?  How to submit to authority?  Which values to have?) For what purpose?  (Job?  College?  Happiness?  Efficiency?)

Do schools exist to prepare kids for life as adults?  How?

Based on your answer to the above, what is the best way for schools to actually accomplish this purpose?



Our district uses apple products like crazy, for pretty much everything.  Every teacher just got a new macbook air last month.  Every elementary teacher also got a new full-size ipad.  Every student in our school in grades 8-12 has their own macbook pro or macbook air (about 30 kids).  In addition, our school has about 25 more macbook pros and macbook airs that kids use on a rotating basis from the office.  So between teachers and kids, that is roughly 65 macbooks.  I bought my last 2 chromebooks for around $150 each.  I don’t understand why we don’t use chromebooks, and save a ton of money, like most districts are doing around the country.   65 chromebooks at $150 each = less than $10,000.  65 macbooks at $1,200 (this is a guess.  I would imagine we probably paid more than this for the pros, and maybe a bit less than this for the airs?) each = $78,000, for a difference of about $68,000.  This is almost enough to pay for another certified teacher at our site – a big deal considering we currently have 6.75 certified teachers. (I should also mention here that our school does have about 20+ chromebooks that a teacher won in a contest, and those are used on a daily basis as well.) . The other day, one of the top guys in the district called my little samsung chromebook “garbage” when he saw me working on it.  He asked why I wasn’t using the macbook air that I had just received, and I told him I preferred the chromebook, which is the honest truth.  Anyway, the district’s decision to go with apple products just seems wasteful.  I inquired as to whether the 300-400 new macbook airs that the teachers just received (and the new ipads) was grant-funded or something and was told that no, it was just how the district decided to spend it’s money.**


I recently saw this in the minutes from a recent LKSD board meeting:

Approved the purchase of the recommended Language Arts materials and resources in an amount not to exceed $982,242 with authorization for additional funding from unreserved fund balance in an amount not to exceed $582,242.

Now, up front I want to say that I have dear friends who have been very involved in the rollout of this curriculum.  This post is not about them.  It’s not even about THIS rollout.  It’s about using this specific example as a springboard for discussion about how/why funding decisions get made in education.  The $1.5ish million mentioned above paid for our new language arts curriculum, the vaunted “Reach for Reading” (RfR) from National Geographic.  Our school just started using this curriculum in August of 2018, in grades k-5 (or 6?).  I know that the fifth grade curriculum alone was like 8-12 heavyish boxes of materials.  4 or 5 boxes of leveled readers, 1 box of “explorer” books, 1 box of teacher editions (4 different volumes), another box with various other materials like the “academic talk” flip book and many others, 2 boxes with the reach into phonics booklets, and more.  Many districts are switching to Reach for Reading, and by all accounts, it is an outstanding curriculum that delivers challenging material with high expectations for achievement, along with differentiated material for ELLs (English Language Learners) and underperforming students.  In LKSD, RfR is replacing a curriculum called “Storytown” that was in wide use across the country, and is probably increasingly on the outs these days.

The thing is, LKSD turns over it’s curriculum on a schedule.  I can’t remember if it’s 6 or 7 years, but the district is constantly rotating through a list, so that 6 or 7 years from right now, we’ll be rolling out another new language arts curriculum at a similar cost, adjusted for inflation and student count.  And keep in mind that the learning curve for the transition to RfR has been steep.  Training in the new curriculum was the main emphasis of the district-wide inservice, which the district spent huge money on, to fly every teacher (300?  400?) to Bethel for 3 days of training – also paying to house and feed them during that time.  I’d guess it cost at least $200,000.**  And most of the teachers are still figuring out how to best use the curriculum.  This period of breaking in a new thing means less effective instruction for our students.

I think this whole process is duuuuummmmmmmmb.

How can Storytown go from being the best possible option for our kids, to being a major problem, in just 7 years?  We face many formidable problems, but Storytown is not one of them.  An above-average teacher could use storytown for the next 10 years and dwarf the progress made by their average peers who are using RfR.  That is my belief.  I’d love to see a study on the actual effects of the 2 side by side, kind of like they discuss here with other factors.  Several times during my 15+ years here, I’ve seen boatloads (literally) of textbooks and other materials taken out of the school to be thrown away.  Some of these were literally never used.  Most were used, but only a few years and they were still in great condition.  But getting anything to/from rural Alaska is very expensive, and our school has one small storage room, so…to the dump it goes.

What if we spent some of that $1.5M to $2M on

  • bonuses for teachers whose students’ test scores went up by a surprising amount?
  • Or on funding effective and inexpensive early childhood education, like parents as teachers programs in every village.
  • Or on bonuses for teachers who stay 5 years, 10 years, 20 years.  Turnover is killing our schools, I believe, way more than outdated curriculum.  Because the learning curve is so steep, in terms of cross-cultural adjustment.  In most rural Alaskan school districts, teachers stay about an average of 2 years, and keep in mind that the replacements are very often 22 years old and just out of college (not super effective teachers).  It’s a bad cycle.
  • Or better teacher housing!  Our building is so old that people literally cannot agree how old it is.  I’ve heard everything from the 30s to the 70s.  It has lead pipes, lead paint in places, and asbestos.  When I drilled into the wall to push a cable through, I found that all of the insulation had fallen down to the bottom couple of feet in the walls.  And there is no room for anyone who wants to have children.  How does that help anyone stay long term, which is what everyone agrees we need?  That $1.5-$2m would be more than enough for a new teacher housing 4-plex at our site.
  • Or how about direct cash compensation to students for good grades, or better yet, higher test scores (go up by X points = Y dollars).  Some districts have already done this, and the results were very promising, and it wasn’t actually expensive relative to the other stuff they had tried.

I’m just brainstorming here, but in 5-10 minutes I’ve come up with a list of things that I’m pretty confident would be at least as good and potentially way better, in terms of ROI, and that “return” based on accomplishing whatever it was you came up with to my question at the top.

And remember, LKSD (and probably most districts) does this every year!  In 2020, Everyday Math is out and we get a new math curriculum.  Our students get very low scores.  Those scores aren’t low because of Storytown or Everyday Math.  We have many challenges, but terrible, unusable curriculum is not one of them.  So why are we spending so much of our limited funding to fix something that isn’t even a problem?  Cynical answer – our test scores are bad, and the administration needs to look like it is taking things seriously and making changes, and it’s easier to change materials than it is to fire people.  Hopeful answer – ????  Incompetence?  People sincerely believe the curriculum is the problem, and is more urgent than our other problems?

**I can understand this maybe if we had more money than we knew what to do with.  But we don’t.  The state of Alaska has been in a budget crisis for a few years now due to falling oil prices, resulting in flat-funding or miniscule annual increases for education.  Our classified staff are in the middle of a 5 year period where their wages have been frozen, because “the money just isn’t there.”  Our certified staff approved a new contract a few years ago that saw our actual pay go backwards, in real dollars, over a 3 year period (village teacher rent increases of 10% per year – these increases were greater than the raises to the salary schedule).

SLP Caseloads

Posted in SLP, teaching, Uncategorized by Pete on March 14, 2016

I’m copying and pasting something from an SLP forum that I lurk on.  This is about caseloads and thought it was a good perspective and I wanted to be able to access it later so I’m pasting it in here.

I have posted this more than once. My rule of thumb is my caseload cannot exceed the number of hours I work over a week. So…if I work 38 hours, I can’t have more than 38 students. In that 38 hours, you are ALL entitled to 30 minutes of duty free lunch daily, and whatever planning time is given to the professional staff in your school. If you are working through lunch and planning time, you are NOT doing anyone any favors…and that includes the district and your students. You are allowing yourself to be taken advantage of.

So back to my rule of thumb. Where I worked, I had 30 minutes of lunch and 30 minutes of planning (planning was averaged out over the week…so really 2 1/2 hours per week) per day. So that left 28 hours in which to do everything else…therapy, testing IEP meetings, consults, classroom observations, report writing, meetings…you get the picture. Even with 28 hours to do all of that per week, I sometimes found myself stretched. When I read about caseloads that are double or triple what I had, I wonder just how FAPE is being met. And I wonder about the real quality of services…and I wonder just how quickly some of you will burn out.

It took me a while to get to the point I was at…that caseload of 30 or so students. Back in 1973 when I started, I had 13 schools and well over 100 students. It was a job that could NOT be done….period. I was at each school once every two weeks. The kids didn’t even know my name.

I immediately became a strong advocate for decent services for my students. NOTE…not for me…for my students. BUT in advocating for my students, I also advocated for myself, and our profession.

Our administration understood that the apraxic, low cognitive student with multiple issues…and multiple weekly consults…took much more of my time than even a multi sound artic case. And I needed to have the time for these things.

I understand that some folks don’t want to make waves because of job security and the like.

But read what you are saying….your admins expect you to make up time with students when you are absent for a day…but they also think it’s good quality services for you to be seeing 60 plus kids per week? I guess I think those are contradictory statements.

If they are REALLY worried about FAPE, they should get more staff…so ongoing services can be better.

Where I am, districts with these larger caseloads also have HUGE turnover in SLP staff…because folks simply move on to districts where the working conditions are better. And yes…that sometimes means a huge cut in pay. But I know a few people who went from having over 75 on their caseloads to under 40 and also lost over $6000 a year in salary. They say…it was well worth the reduction in salary to be able to provide a quality service to their students.

As a profession, we need to stand up and be counted. Do the special ed teachers in your district see 60 or 75 kids per week? How about OT and PT? If you are in a primary school….what classroom has 60-100 kids?

Please…advocate for quality services for your students. And for heaven’s sake…stop short changing yourselves by working through lunch and planning times…and taking hours of work home nightly.

OK…off my soapbox.


And someone replied with:

I think everyone can reply to this question but not much can be concluded.  Numbers do not reflect workload.  I think that is where administrators loose perspective on appropriate staffing.  So much goes into determining workload for any specialists.  Everything from severity of students to universal supports provided in a school system.  I personally could service 30 articulation kids over a couple of days with my eyes closed but give me 30 more involved students and the game changes.

We all need to advocate for reasonable workloads and numbers.  The amount of work, paperwork and meeting time that is required for each student also need to be taken into consideration.  I also find that administrators have little to no understanding of the process of language development nor how decreased language abilities impact academics.

This past year I published a book,  The School Speech Language Pathologist,  An Administrator’s Guide to understanding the role of the SLP in schools along with strategies to aid staffing, workload management and student success.  It’s just a start in educating administration.  Available on Amazon and through my publisher Booklocker.

I think it would also be interesting to know how much turnover occures because of workloads/caseloads that are too high an unmanageable.  My 30 years of experience can also state that staffing levels have not grown over the years but numbers have.  Think about that.

I didn’t write either of these but they are good food for thought, for me at least.  I’ve wrestled since before I became an SLP with the service delivery model used in the Alaska bush (at least in my home district of LKSD) and this applies to that issue.

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How Many Clocks?

Posted in teaching by Pete on March 7, 2012

I was walking home just now from school and surprised 2 little boys who were struggling as they walked through the deep, soft snow and biting wind.  One of them said “You let me…scared!”  And then, “Visit?”  I told him no, maybe later, and kept walking and went up the stairs of our apartment.  As I reached the top of the stairs, he shouted back “How many clocks??”  I said “What??”  He repeated the question and I realized he meant “How long until we can visit?”  I told him “Maybe tomorrow” as it was nearly 6 o’clock and time to start making dinner.

I liked the interaction as an example of “village English” which we often enjoy.  You let me scared = You scared/startled me.  Visit? = can we come in to your house and play for a while?  This kind of dovetails into the post I wrote about “meaningful differences” and the interaction between culture and language development.

meaningful differences

Posted in teaching by Pete on February 21, 2012

This is my 3rd or 4th attempt to write about this.  Each time I write too much and make it too detailed and complicated (luuuv those details so this is generally a problem for me, esp in writing).

There is this book called Meaningful Differences in the Everyday Experiences of American Children, by Hart and Risley.  As an SLP (supposed to be an “expert” in human communication and communication development in children), I enthusiastically recommend it.  It is not new, and it is all about a gigantic longitudinal study done decades ago in a far away part of the country with families who share very little in common with my neighbors.  However, I think the conclusions of the book have profound implications for the people of western Alaska.

I’m going to steal some of the book description from Amazon and paste it here:

“Betty Hart and Todd Risley wanted to know why, despite best efforts in preschool programs to equalize opportunity, children from low-income homes remain well behind their more economically advantaged peers years later in school. Their painstaking study began by recording each month – for 2-1/2 years – one full hour of every word spoken at home between parent and child in 42 families, categorized as professional, working class, or welfare families. Years of coding and analyzing every utterance in 1,318 transcripts followed. Rare is a database of this quality. “Remarkable,” says Assistant Secretary of Education Grover (Russ) Whitehurst, of the findings: By age 3, the recorded spoken vocabularies of the children from the professional families were larger than those of the parents in the welfare families. Between professional and welfare parents, there was a difference of almost 300 words spoken per hour. Extrapolating this verbal interaction to a year, a child in a professional family would hear 11 million words while a child in a welfare family would hear just 3 million. The implications for society are staggering: Hart and Risley’s follow-up studies at age 9 show that the large differences in the amount of children’s language experience were tightly linked to large differences in child outcomes. And yet the implications are encouraging, too. As the authors conclude their preface to the 2002 printing of Meaningful Differences, “the most important aspect to evaluate in child care settings for very young children is the amount of talk actually going on, moment by moment, between children and their caregivers.”

To oversimplify it – future academic outcomes for these children were correlated very highly with their word count exposure as little kids.  Not what they were listening to between 2 other people, or on the radio or TV, but language they were involved in as an active communication partner.  There was a much higher correlation between word count exposure and later success in school than there was for race, socioeconomic status, parents level of education, or any other competing possible causal factor.

So what are the implications for a whole population that is, by dominant culture standards, very nonverbal?  We have all of these schools here that are “failing” under NCLB, and a large part of our students’ academic struggle is their difficulty with language.  Vocabulary, syntax, being able to understand or relate a coherent narrative, picking out or relating key details, making inferences, main idea, understanding verbal directions from the teacher, etc etc.

What if the main issue is a deficit in the amount of talk going on between the child and their peers and caregivers, particularly in the earliest years??  Yikes.  I’ve never heard anyone say this, but isn’t it an inescapable implication if you believe in the study’s conclusions?  Without making a value judgement, Yup’ik is a more nonverbal culture, compared to the majority culture.  The Yup’ik language is far more content-based and “telegraphic” than English, eliminating non-essential words.  After 8+ years here, the sparse, terse nature of the speech reminds me of how people live.  No wasted effort, no extra words, a survival-based commitment to parsimony.  And this carries over to how most of my neighbors speak in English.  If you’re at a feast, you don’t hear “Will you pass the salt please?”  There is no Yup’ik word for “please.”  You hear “Salt.”  The local schools have big community meetings once or twice a year and have door prizes (get a ticket at the START, drawing at the END) to encourage people to come and stay because it is hard for people to endure what is (in their view) the excruciatingly long-winded presentations in English, full of superfluous words that obscure the main point of the meeting.  The words are too numerous, come too quickly, and without sufficient pauses, so processing is difficult and tiring.  And the delivery is not direct enough, using a few words they don’t know, many words that are seemingly unnecessary, and not enough content words that matter.  The listeners have to unpack everything to find the telegraphic speech they are more accustomed to.

So what is to be done?  Many area schools have recently been cutting or altering the bilingual component of the school day, apparently in the belief that it will help kids learn.  I find this regrettable.  We try everything – extra tutoring, CSI, RTI, teachers presenting lessons in multiple modalities, the latest and greatest curriculum materials like storytown, everyday math, etc etc in a desperate effort to find something that will work.  I don’t want to make a generalization that is too broad or explosive, but in my limited experience I see village teachers that work much longer hours than their urban counterparts.  Teacher effort is not the problem (though turnover IS part of the problem, but that’s another post entirely).

Big, uncomfortable question time.  Is our kids’ nonverbal culture “holding them back?”  Well, from one perspective maybe.  But holding them back from what?  The materialistic, non-existent “American Dream?”  Maybe the culture and community of the village is a better alternative to the greed and loneliness of suburbia.  What is the point of school?  To go to college so you can marry another college kid and make big $$?  What if you want to live your life in the village, connected to your extended family and the land, where there are fewer jobs and none that make big $$?  What are we preparing kids for?  For a job? Where?  For life?  For college?  As educators we often have to have high expectations for our students and help/prod them to reach those expectations.  But what if your expectations for the kids are not what the students want, not what the parents want for their kids, and not what really anyone in the community wants?  This is the case in some villages, to varying degrees and it obviously causes major problems.  How much say do we give the local community in what/how their kids learn?  The stock answer is “a lot” but I don’t know that that is true.  The districts select the curriculum to learn the material outlined by the state, and the districts set forth some narrow parameters that the village school boards can move around within.  What if the local community said we don’t think kids need writing or reading class beyond the 8th grade level?  What if the community wanted to instead pay more attention to the emotional health of the students, to stem the tide of abuse/despair/addiction/self-hatred/suicide etc?  Is that a bad thing?  The western model we’re using now isn’t working in a lot of the schools – do we keep tinkering or when do we blow it up and try something new?  Under NCLB they can eventually fire the whole staff – but the staff isn’t the issue here, it’s more like the educational vision/model/framework and the interaction between two radically different cultures.  I have no easy answers.  But I got started writing this post because the conclusions of the Meaningful Differences study are compelling and seem legitimate and very applicable to the “failing” schools of bush Alaska, yet I’ve never heard a word about it.  So there it is and now you know.  ; – )

When I think about all this it only reinforces the critical need for local leadership and “ownership” of our schools.  Without ownership of the school and the programs therein, there is a disconnect that strips the school of relevance and authority and results in kids/parents/communities that don’t care or are openly hostile to what they perceive as an unnecessary, burdensome, alien program.  With ownership you instill commitment and purpose, and an intrinsic motivation to learn.

bush groceries

Posted in teaching by Pete on February 8, 2012

I help answer questions over at the ATP Forum, which is a place for prospective teachers in Alaska to ask questions.  A common question people have is about budgeting for food, as they try and get a better idea of what a move to Alaska would mean for them financially.  I’ve put a lot of thought and work into grocery shopping in the past and thought I’d put up some of that on here and tag it as ‘advice’ so it might be helpful to someone doing this kind of research.

If you choose to shop in a major hub like Bethel, Kotzebue, Dillingham, Nome, Barrow, etc you will probably have a couple of stores to choose from, and they may not look very different from a smallish lower-48 grocery store except for the prices.  Here is a youtube video someone made of a recent trip to the AC store in Bethel.  And here is a link to the weekly specials for Swanson’s grocery store that appear in the Delta Discovery newspaper. These give you a small idea of pricing.  Of course if you live in an outlying village as we do then you need to pay another fee to have the boxed groceries delivered to an air carrier and sent to your village (our village is only a 15 minute flight and the fee is about $.50 per pound), or have a friend pick up the box for you.  Both AC and Swansons will shop your list for you and box it for no extra fee if you fax or call them with what you want, and pay by credit card over the phone.  They are both based out of state.  I believe Swanson’s is owned by Omni Enterprises out of WA state, and AC (Alaska Commercial company, which has quite a colorful history in the state dating back to the Russian days when they had a monopoly on the Pribolof seal harvest – try google) is now based in Canada.

Of course you can also shop in your village itself, which helps the local economy.  Village stores vary widely in quality and selection, based on factors like distance and number of flights from Anchorage, and management.  I’ve seen villages with three stores, while others have none.  Most common is one or two stores.  Some village stores have surprisingly good quality of dairy and produce, while others have only a few half-rotten choices.  But usually there is not a lot of variety, and things run out of stock on a regular basis, as in “there are no eggs today.”  It can be difficult or impossible to get a lot of dairy items like milk, cream, whipping cream, cheeses, ice cream, etc.  Some village stores (esp in larger villages) have these things, but most do not.  Same goes for veggies.  Our store in Kasigluk most often has root vegetables such as potatoes, carrots, or onions, but also tomatoes and cabbage  and apples are fairly common, though the quality might be understandably below what you’re used to “outside.”

Our local store pricing is actually not very different from the prices in Bethel.  This is because the cost to mail goods from Anchorage to Bethel is the same as mailing from Anchorage to Kasigluk.  The main difference is in the variety and availability of what you might be looking for.  As for cost, it is expensive, no doubt about it, although if you have a line of credit with the store and pay it off in full every month you enjoy a 10% discount on everything.  But the price is still high, particularly for items that cannot be mailed such as bleach.

As an example, I recently brought in a “hazmat” barge order from Anchorage consisting of paint, bleach, motor oil, fire extinguishers, etc and sold off the bleach and motor oil in order to cover the cost of buying and shipping the paint which we were using to spruce up an old school bunkbed our kids started using as well as some other stuff like painting our conex container.  Anyway the bleach at costco in Anchorage was $6.24 for a 2-pack of clorox jugs each weighing 182 oz.  One of those jugs sells for $47.31 at our store in Kasig (yes, about 15x as much).  With barge fees my total cost ended up being about $8 per jug to Bethel, and then I found a way to get everything to Kasigluk and sold them for $20 each and all 20 of them sold in a week or so.

One avenue for fresh produce that has become very popular in the bush lately is Full Circle Farms and other CSAs.  It ain’t cheap.  We pay something like $60 or $70 per box of fresh produce.  But the quality is outstanding, as is the web-based interface where you select exactly what you want for each delivery.  We get mangoes, kale, lettuce, spinach, tomatoes, fresh thyme, oranges, kiwis, zucchini, pie crusts…you get the idea.  It is Expensive with a capital E but in my view worth it when you consider how difficult/impossible it is to get otherwise.  We get a box every other week for our family of 4.

Another recent option that has come along is buying groceries on amazon.  When we first came here in 2003 this was an option, but then they changed the rules so groceries could not ship to AK.  But just a year or two ago they made it available again.  Generally speaking this option is a little more expensive than paying a company in Anchorage to buy and mail it to you.  But it is easier, and sometimes the prices are competitive or even better than if you go through Anchorage.  For example I’ve found that the prices for cereal are quite competitive with what you would pay a middle man to buy it at Costco and mail it to your village.  But on the other hand, laundry soap is far cheaper via Anchorage.  Some of this has to do with shipping.   Shipping from Anchorage costs about $.35 per pound for a heavy box going parcel post, say around $20 for a 50# box.  From the lower 48 the same box costs far, far more to send and takes longer, which is why going through Anchorage is generally cheaper than amazon.  But it’s tough to beat the convenience and selection on amazon if you don’t mind paying a bit more.

This is long enough, so let me just link to our old website (that cannot be updated) for information on shopping in Anchorage.  You can do it yourself, or use a middle-man company to shop and mail it to you, and this website explores these options in some detail.  This information is all 5 years old or something, but still useful.  The company I most highly recommend based on price, JB Bush, still exists but has changed their name to Alaska Bush Shoppers, not to be confused with Alaska Bush Service (same initials but different company) who I compare JB Bush to on the website.  Confused yet??  🙂  Hope this is helpful information.

bush medicine

Posted in teaching by Pete on February 20, 2011

It’s a Saturday night and I find myself setting up my sleeping bag on the floor of a building in the Western Alaskan hub city of Bethel.  My infant son sleeps fitfully on the other side of the room.  We flew to Bethel to go to the emergency room at the hospital, the only hospital for hundreds of miles, and we are waiting until 5 or 6 am to go to the E.R.  Every so often we have these experiences that are so outside of the “norm” that I grew up with that I want to tell the story to let people get a glimpse of life in the bush.

Two weeks ago, we couldn’t use our usual babysitter because her son wasn’t feeling well, had a fever, and ended up being diagnosed with an ear infection.  On Friday of that week we were looking for a sitter and I called them up and they said he was better, he was fine.  I dropped our kids off and then flew off to Napaskiak with the boys for some high school basketball (I’m coaching this year).  On Monday I had to get to Atmautluak to test a student before their IEP became due.  I took them to the same sitter.  I returned home around 5 pm and my wife told me we had to pick up our kids ASAP because the sitter had called to report that our son had a fever.

I went and picked the kids up, and he didn’t look good and was fussy.  We got home and I checked his temp and it was normal.  A couple of hours later and it had climbed to 100 or 101, and we gave him some ibuprofen.  This brought it back down, but after 4 or 5 hours the fever and fussiness would return, and generally speaking each was worse than the one before.  On Wednesday morning I was planning on calling the clinic and getting him an appointment.  But when he woke up, he had no fever.  Hooray!  I thought his fever had broken.  No.  By lunch time he had a fever that was 102 or 103.  It was too late to call the clinic.  You cannot get an appointment unless you call in the morning, and they stop seeing patients in the early afternoon.

So I called at 9:00 on Thursday morning and got an appointment for 11:00 am.  I called Tammy and she said she would go with me to the clinic since I can’t drive (snowmachine or the school truck) and hold the baby at the same time.  I called our other babysitter and she agreed to take our daughter while we took our son to the clinic.  Tammy had to wait for her sub and then explain to him what she wanted done with her classes, so that when she arrived we were running late.  She hadn’t had time to have breakfast or lunch yet.  We piled all four of us onto my Polaris 550 with the sticker that reads “Not intended for use by more than two people at any time,” and drove to the babysitter’s and our count went down to three.  From there to the clinic, driving slowly because of the precious cargo, the new pistons in my snowgo (another story), and the difficulty seeing the dips and bumps and gulleys along the way.  Tammy was on a snowgo that turned over a few years ago and she has some (justifiable) fear of this happening to her while holding the baby.

A mile and a half later and we were safely ensconced within Kasigluk’s large new clinic.  We saw a health aide who gave the baby a thorough inspection.  The health aides use the “Community Health Aide Manual,” aka the “health aide bible,” to help guide their physical inspection and patient interview.  After checking temp, oxygen, ears, nose, throat, heart, lungs, etc, the health aide felt that maybe we should take Bobo in to Bethel to see a doctor.  Very quickly if you don’t know already, the community health aide is not a doctor, physician’s assistant, nurse practitioner, nor a nurse.  They are trained in some basic medical knowledge and trained to gather the data and then fax (yes I think they are still FAXing) the information to the YKHC (Yukon Kuskokwim Health Corp) hospital in Bethel, where a doctor or nurse practitioner or physician’s assistant will read the report and then respond with the course of treatment.  The clinics are stocked with the most common prescriptions.  If you want to know a lot more about the community clinics, the health aides, the physician’s assistants and others in Bethel who work with the village clinics to prescribe meds and medivac serious cases, you can check out the now defunct Tundra Medicine Dreams blog.  Lots of good writing from a P.A. who used to be on the Bethel end of the service delivery model.  The village clinics, as well as the YKHC hospital, are all a part of the vast Indian Health Service, providing free health care to nearly all of my neighbors.  YKHC serves as the primary hospital for something like 56 villages.

Back to the story.  They were concerned about Bobo’s chest and lungs, based on what they could hear in his breathing, and felt he should go to Bethel, and the doctor in Bethel agreed.  However, it was too late to get an appointment for that day.  Our options were to go and sit in the E.R., or wait to the next day and call at 8:00 AM sharp and get a same-day appointment.  The last time we tried to do this I called over and over and only got busy signals or voicemail until 8:45, at which time someone answered and said the same-day appointments were all taken.  On that occasion, Tammy then flew in with our daughter and sat in the E.R. from roughly 10 am until 4:30 pm without seeing anyone and then she gave up and caught the last plane back to Kasigluk.  Our girl got better on her own, and Tammy figured that sitting in the crowded E.R. full of very sick people was not going to help things improve. We weren’t sure what to do.  One of the health aides advised us that the E.R. gets very crowded in the evening but if you go before 5:00 or so you can usually get seen right away.  They also mentioned that a plane was coming in the next couple of minutes, and we should try and get a seat as the next plane wouldn’t come for several hours.  We had no change of clothes, not for ourselves nor for the baby.  We had 1 extra diaper.  We decided to go for it.  We wanted to do what was best for our boy.  Less than five minutes later, Tammy and Bobo got the last seat on the 6-seat Yute Air 207 for the 15 minute flight to Bethel ($88 each way!).

Upon arrival in Mamterillermun (Bethel in Yup’ik), they headed via taxi ($8) to the E.R.  She got there around 2:00 pm and it was crowded.  She saw the triage nurse who told her it would be a long wait to see a doctor, even by their standards.  But the wait for the chest x-ray would not take more than a couple of hours.  Also, she was able to schedule an appointment for a doctor the next day, so she decided to wait in the E.R. for the x-ray, then take a taxi ($8) and check in to a hotel ($170).  Tammy is not the last of the big spenders, but with airfare, hotel, taxis, 4 meals from restaurants, clothing and diapers from the store, our 40% share of the medical bills (YKHC is not a “preferred provider” with our school district health insurance despite being almost the only option for hundreds of miles, go figure)…the whole trip cost upwards of $700.  Bethel and the bush in general can be very expensive.  Small demand, but teeny tiny supply.  She also had to order food (first she’d eaten all day, around dinner time) for her and the baby, she went to a store with the baby (cab ride) and bought him a change of clothes, diapers, etc, and even bought some hand-made booties made by a woman from our village because in our haste we had taken him to the clinic in a snowsuit and pajamas but no shoes.

After a rough night during which his temp climbed as high as 104, they took a taxi to the 10:40 appointment at YKHC on Friday morning.  He was given amoxicillin for otitis media (bad ear infection) and the x-rays were examined and they were negative, no problems.  So just a flu and ear infection combination.  They headed to the airport after getting meds from the YKHC pharmacy around 12:30.  OH, and by the way while at the hospital Tammy saw people who had been in the E.R. when she arrived the day before at 2:00, they got there before her.  She asked when they were seen by a doctor, and they told her 4:00 AM!  So it would have likely been more than a 14 hour wait in the E.R. had they stayed, with almost no sleep surrounded by lots of very sick people.  I think they made the right call about getting a next day appointment and going to a hotel! At the airport they found out noone was flying due to fog and snow that kept going up and down.  To cut this part of the story mercifully shorter, they waited all day and did eventually make it home around 7:00 pm.  Yute Air told me around 4:30 that she was on the plane and on the way, so I headed over to get her using the school truck, and with Claire.  By 6:00 Claire was cold (truck has no heat) and my hands were getting seriously cold too.  These sorts of miscommunications are commonplace with the small Bethel airlines, more the rule than the exception.  I took Claire home, and found a message on the machine that she had left Bethel already, so I raced back to the airport and waited another half hour or so and then they came in (she was delayed because the plane went to another village before it reached KUK).  Hooray!!  We drove home, and though Bobo was still noticeably fussy and tired, he seemed much better already, not needing to be held every second.

This was not the happy ending we thought it was.  On Saturday morning, after giving the baby his 2nd dosage of amox, Tammy noticed his back was all splotchy.  She remembered the pharmacist telling her that if he had a rash, to stop the meds immediately because it indicates an allergic reaction that would start as an isolated rash, then move to a rash all over, then move to difficulty breathing if he stayed on the meds.  I was coaching basketball at the school and not reachable.  She called the on-call health aide (the clinic is closed on weekends but they have a clinic cell phone that is answered 24/7 for emergencies), but was told that they couldn’t see him unless it was an emergency, but we could bring him in on Tuesday (Monday is a holiday and they are closed).  He has been sick since Monday, today is a Saturday, we didn’t want to wait another 3 full days to get him on the right antibiotics.  We called the YKHC E.R. and asked how the wait was, they said it was terrible, and when told why we might bring the baby in the person said the health aide should take care of it for us.  I went and spoke with the health aide, a family friend.  She was sympathetic and nice, but it sounds like she isn’t really allowed to intervene after hours except for real emergencies.  I explained that I’m concerned about the ear drum rupturing, and the high fevers returning, and he has been sick long enough, he hasn’t been eating hardly any solids for several days, etc.  She said that sometimes they will drain (through a perforated eardrum) even after getting on antibiotics, and said “If it drains then it’s meant to drain.” She wasn’t very concerned.  I don’t say all of this as a criticism.  The health aides do a really good job.  They have saved our bacon more than once, even once when Tammy broke her leg and they helped get her on a plane in a snowstorm.  But the healthcare is not what you can get in most of America after a short car ride.  You may have to wait until Tuesday.  Or you may have to pay to get on a plane, and then a cab.  And then wait a long, long time.  I think the Indian Health Service gets away with it because (1) hey, it’s “free” healthcare (in exchange for natives giving up land claims and other claims against the State) and (2) Yup’iks don’t complain.  It is not a Yup’ik value to complain, or be verbally assertive, aggressive, or pushy, or to call their congressman.  Things simply are accepted that would be “unacceptable” in suburban, white America.  And that gets taken advantage of sometimes by the kassaq institutions out here.

These sorts of interactions between cultures can be pretty fascinating, and its the kind of interesting interplay you can get a lot of on the aforementioned old Tundra Medicine Dreams blog.  My neighbors accept suffering with a lot of patience and stoicism.  Some outsiders might even say fatalism.  As a speech-language pathologist (SLP) I deal with kids with speech (articulation) and language delays all the time.  And I know that kids with recurrent otitis media and perforated eardrums are far, far more at risk for delays, and even behavior problems, than kids with healthy ears.  I also know from my dealings with audiologists in this region, that they all say that they’ve never, ever seen ear problems like we have out here, in terms of severity but mostly in terms of rates of incidence.  It is very common for kids here to go to ANMC in Anchorage for ear surgery to repair perforated eardrums.  When I say very common, I don’t have a percentage, but maybe 10% of all kids?  Maybe more?  These are kids who have grown enough to have the surgery.  You can’t have it as a  young child because your eardrum is still growing and the repair may not work.  So they live several or many years with the hole before it is patched, meaning they go through a lot of developmental years without proper hearing.  So needless to say, this is one cheechako/kassaq/dad who does not believe that my kid’s ears are meant to drain.  Us kassaqs are arrogant enough to think we can control such things.

I flew in to Bethel with Bobo on the last plane before the ceiling (poor visibility) came down on Saturday, just an hour or two after the visiting basketball teams had flown home.  Our friend Deanna drove us over on our snowmachine because the truck wouldn’t start (it is below zero today and it’s not plugged in) and Tammy (a) doesn’t know how to drive the snowgo and (b) needed to watch Claire.  We actually strongly considered flying on to Anchorage, because it is possible to get a mileage ticket that will fly us from kasigluk to Bethel to Anchorage, and it costs no money and only 15,000 miles.  Remember that Tammy just spent several hundred dollars on Thursday and Friday.  It can actually be a lot cheaper for us to get on a jet and fly 400 miles to Anchorage where we have our own car, friends to stay with, and medical that is covered at 90%.  Crazy.  But the ERA flights from BET-ANC were done for the day, and I didn’t want to spend 3 hours in the terminal waiting for the 8:30 Alaska Air jet with Bobo so I decided to stay elsewhere in Bethel, after calling the E.R. and being told they were “slammed.”  The guy said it has been that way for 2 weeks since the flu has been going around. I figured its better to get a good night’s sleep and go in at 5 or 6 am in hopes that we don’t have to endure the 14+ hour long wait.  Hopefully we can make it home by the Sunday evening flight, with antibiotics in hand that fix my son’s ears but don’t give him an allergic reaction.  I am sure he is even more tired of this whole process than his parents!

Living and teaching where we do is such a unique experience in almost every way from the “norms” of our majority culture.  And there are tons of things we love about village life.  Other aspects are difficult.  It’s different out here, for better and for worse.  I need to remember that we are richly blessed to be able to hop on planes and get the help we need.  It was not at all this way in Kasigluk when I was Bobo’s age.

first day of school

Posted in teaching by Pete on August 19, 2008

Our school appears to have a great staff this year!  They are all working hard and seem like they truly enjoy kids.  Noone just marking time until retirement.  Our principal will retire after this year, but he isn’t like that and is finishing strongly.   We are very lucky to have such a principal who really loves the kids, who fights for them, cries at graduation, etc.  When we travel to other schools for sports, sometimes we realize how great we have it.  (And no I’m not brown-nosing — nobody on the school staff reads this blog)

Anyway, yesterday was the first day of school, and there was a great energy to the day.  The young ones always try to come hours early, they’re so excited.  One little guy came home from a half-day of school and went right to bed (kids are still on summer schedule, staying up until 2 am or later and struggling to get up for breakfast at school at 8:15).  When he awoke, his mom said he got dressed for school and was ready to go, but it was only 4:00 in the afternoon or so!  After school was a staff meeting and cross country practice and then we had a 2-hour open gym in the evening.  Some kids just hang out at school from about 8 am to 9 pm!  Our staff consists of 1 student teacher, 1 first year teacher, 1 second year teacher, 1 third year teacher, 1 6th year teacher (Tammy), 1 veteran (maybe 20 years?) certified teacher, 2 veteran classified teachers (teaching in Yup’ik), and Carl, our longtime principal.

I think it’s going to be a good year at Akiuk Memorial School, for learning and having fun.

polystyrene (styrofoam) trays

Posted in teaching by Pete on August 18, 2008

So here is a random topic I’ve chewed on for a few years (no pun intended) and was just reminded of by a colleague. Our school district, like New York City public schools, uses styrofoam (well technically it’s called polystyrene) trays to serve breakfast and lunch to all students everyday. Keep in mind that our village dump is actually just a spot on the tundra half a mile from the village on the edge of a lake and everything is burned from time to time. So we’re paying for these trays, which appear to cost between $35 and $70 per case of 500.

Now keep in mind the shipping will greatly increase that cost. The district might be paying as little as $55 per case if they’re getting a good deal. Then there is the cost of driving over to the post office and picking them up (1.5 miles each way by boat or snowmachine, and school employees do this on the clock), and then 3 full trash bags that they fill (per meal), and then the cost of hauling those full trash bags by the handcart load out of the school, down the boardwalk to the school dock to the school boat and to the dump (.5 miles each way and again on the clock). This doesn’t take into account the environmental cost, nor the supreme irony of everyone in the lower 48 getting bent out of shape over global warming that is mostly only affecting people in the remote north, while we in the remote north burn our styrofoam to save a little $. Penny wise, pound foolish, I suspect. But this is what I wanted to examine, to find out.

So I thinking we’re paying at least 11 cents per tray just to get them to the post office. Then the gas (at $6 or more per gallon) to haul them everywhere and the salary of those doing the hauling, plus using up the big trash bags when they’re done. I think I can quite safely say 13 cents per tray. So we have about 65 kids and some staff and community members who eat at school every meal, so lets say 80 trays per meal. 80 trays * $.13 = $10.40. Meanwhile, we live in an area (see Wade-Hampton Census area and Bethel Census area) with outrageous unemployment over 25%, where you have no difficulty finding someone who would be willing to wash 80 reusable trays in an hour for around $8 in pay.  And if our district is paying a higher price than they should for the trays, and if I’m underestimating the other incidental costs, maybe it’s as much as 18 cents a tray, which would come to $14.40 per meal, about enough to pay for TWO hours of dish duty.  So…wouldn’t it be cheaper to go with the environmentally friendly, reusable lunch tray? I know this is a simplistic analysis, but surely I’m in the ballpark.  Correct me where I’m wrong.

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warm bodies

Posted in teaching by Pete on April 20, 2008

I get copies of messages posted on the Alaska Teacher Placement forum.  It is THE site for those interested in teaching here, and you can visit them here.  The forum is where people ask questions in pursuit of better understanding of what they’d be getting themselves into.  Anyway, today I got a copy of a post with the subject “Getting to Kwethluk.”  Here is the message:  ***UPDATE – This thread has been generating a lot of traffic and I don’t want this new hire feeling singled out or ashamed.  I’ve changed the places they’re coming from and going to, and I removed the exact age of their child.***

is there any way to drive from the lower 48 (Phoenix) up the can-am (or whatever it is called) highway to Bethel-then put my vehicle on a boat to the village (Kwethluk) so we’d have a vehicle?(4wheel dr)?? Considering I’m coming with a middle schooler, 2 dogs, a cat, LOTS of books (heavy to ship $$$) #’s of boxes I thought it might be less hassle and possibly cheaper.

My intention here is not at all to mock or demean this person.  I just feel for them.  Not knowing if you can drive to Bethel or not?  It sounds like she already has a job and has signed a contract but doesn’t know the most basic information about this part of the world.  As a single teacher your first year in the village is stressful and very hard work in the midst of major culture shock and transition.  Having 1 pet is hard, because you don’t have the time to give them what they need.  Having 3 is going to be tough.  Can you imagine the three animals rattling around inside a little apartment for 6 months of winter?  Now the son/daughter might help give the animals attention, but giving them the time they need will be tough too, and he/she will probably need more than ever due to the culture shock.

Its just hard that we’re so desperate for teachers that we bring in lots of well-meaning, nice people and throw them in completely over their heads and then we bemoan our teacher turnover rate.  I’m not trying to single out any particular school district or that person or anything, this is par for the course.  I believe the average stay for teachers in LKSD, my district, is right around 2 years.  Someone correct me if I’m wrong. 

I think this might be the most devastating hardship that our village schools deal with.  New teachers usually arrive in the village less than a week before class starts.  They’re trying to unpack and find which box has the spaghetti so they can eat, and set up their room, and how do I get to the post office so I can find my boxes, and they’re often just learning what classes they’re going to be teaching in 3 days!  They’re tripping over the cultural differences all around them and making all kinds of questionable assumptions about their neighbors based on misunderstandings.  They’re intimidated about teaching (which is totally normal), sleep-deprived, and stressed out.  And often they have to figure out a curriculum that might be totally unique and nothing like they prepared for in school, like LKSD’s phase system.  If you ask many veteran teachers, they’ll tell you that the first year they did a pretty lame job teaching a lot of the material.  Not because they were lazy or at fault in any way, they were just new and totally overwhelmed and learning as they went.  Someone told us that your first year teaching in the bush is like getting run over by a train.  And the next year you see the train coming but can’t get out of the way in time, and the third year you MIGHT get out of the way barely, and then each year keeps improving.  This is only our 5th year, but its totally true in our experience.  When we have a first year teacher who leaves after 1 year, the next year we’ll often discover they spent the first semester treading water for the most part and the kids are way behind or there is little documentation of progress as there should be.

We sell the experience to college seniors as “adventure,” which it certainly is, and they want to believe “high pay,” which it mostly isn’t when you consider the cost of living & travel.  But don’t we owe our kids better than an “adventure” when it comes to knowing what kind of education they’ll get?  I think the thing we need to stress to prospective teachers is how very different the local culture is here.  This is less true in hub villages like Bethel, Nome, Barrow, etc.  But new teachers think the weather will be hard.  Or not being able to ever have a drink, or go shopping or to a movie, that will be tough.  Those things are pretty trivial compared to the culture shock most teachers find themselves in.   “Why won’t anyone answer me when I ask a question?  What did I do to them??  Even the native staff won’t look at me or answer my questions!  Or I don’t hear them and say “What?” and they don’t answer!”  Or “Why don’t people get plumbing in their homes?  What is wrong with them?  How can they be so lazy/nasty?”  “My only toilet is an incinerator toilet!?!” “My student has a BOIL on his arm – don’t these people take showers?!?”  “Why are these kids always harassing me wanting to VISIT at 11 pm??”

I know I move onto controversial ground, thin ice, when talking about culture.  Every culture has its strengths and weaknesses.  Alaska is made up of many different cultures and I’m not going to be so foolish as to try and list my take on all of them here.  But teachers should expect something similar to moving to the third world to teach.  They might not have running water, they might not understand their neighbors (language or behavior!), they might be forced to live in what they consider lousy housing and possibly with a roommate(s).  They might believe they’re being judged by people and they don’t even know why or what they did to offend anyone.  The huge cultural transition is a complex thing, not to be taken lightly.  But how do you educate someone about this at a job fair in a fancy hotel?  I think for the most part its not talked about that much.  If they had these expectations, the only surprise they might get is a pleasant one.

I realize that I’m throwing lots of stones so far and not providing any answers.  I don’t know.  There is no easy answer or don’t you think we’d have implemented it long ago?

I think its great if people can visit prospective villages before signing contracts.  Yes, expensive.  Maybe the district could agree to reimburse them for half of the cost only 3 months after they start teaching, so if they visit then say no thanks they get no reimbursement.  They could sleep on the floor of the school–the point is not a half-price vacation for 22 year olds.  Of course this would still be a cost for the districts, but I believe it would cut back on 1 year teachers (and especially the rare teacher who shows up, sees the village, and immediately leaves, which does happen occasionally).  Maybe they could get half of it reimbursed after their first year teaching, and the other half after their 3rd year or something.

In addition, I think teachers should be encouraged to live in the village in the SUMMER with reduced rent during those months.  Something really small just to cover utilities like $300/month.  My district is  penny-wise and pound-foolish in this regard, charging full rent for June & July if you stay (and even a “storage fee” for your stuff if you leave it).  We spent our first 3 summers here, and it would be every summer except I’ve been required to do summer internships in Anchorage for my master’s degree.  We think its the best time to be here.  Totally relaxing, beautiful, warm.  You sleep in and read and get your classroom and planning ready at a nice pace, while your neighbors work feverishly all summer fishing & hunting & berry picking, stocking up for the year.  We go with them sometimes and have a blast.  Anyway, by charging full rent, teachers are out of here to see friends and family.  Maybe if they could stay for cheap, some would leave to see friends and family but then return for the bulk of the summer.  They could form relationships with the village outside of their role as a school authority figure, play with the kids, go to feasts, go berry-picking and fishing with people, etc.  Totally different from the school year, and an experience that would help them understand the village better, and help the village understand THEM better, and ultimately that can only lead to more positive results.  Hardly any teachers stay at this point, so I don’t think this would reduce district revenue much, if at all.  Relationships are key to people being happy and staying, but new teachers have no energy or time to form those relationships during their first year or two.  So let’s be creative and make it easier to be there in summer!

My only other ideas are problematic.  A big bonus after every 5 years with the district?  I don’t like that it would be an incentive for bad teachers to stay (which reminds me of another soapbox of mine, I wish it were easier to get rid of the really bad teachers/principals, who are rare but they do exist and most people onsite know who they are).  Or some kind of merit pay or reward system?  I know the Chugach School District does this, or at least they used to.  Its based on a combination of factors like academic performance of students, parent/student questionnaires, etc.  The union would blow its stack at these ideas, but its a way to pay the best teachers a bonus and hopefully help them to stay.  Like I said, these ideas are problematic.  If you have an idea to add, put it in the comments!


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